Individual provider Active NPI

Dana J. Shaheen, PA

  • Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1255360772
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 16357 Issued in CA
Practice address
2271 S. Depot Street
Santa Maria, CA 93455
Phone
(805) 922-0561
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 16357 CA Primary

Addresses

Primary practice location

2271 S. Depot Street
Santa Maria, CA 93455

Mailing address

2271 S Depot St
Santa Maria, CA 93455-1216
Phone (805) 922-0561

Other practice location 1

217 W Central Ave Ste G
Lompoc, CA 93436-2830
Phone (805) 735-4292

Other practice location 2

877 Oak Park Blvd
Pismo Beach, CA 93449-3292
Phone (805) 474-8450

Other practice location 3

5920 West Mall
Atascadero, CA 93422-4232
Phone (805) 466-0676

Other practice location 4

1102 E Clark Ave Ste 120A
Santa Maria, CA 93455-5175
Phone (805) 332-8185

Other identifiers 1

IdentifierTypeStateIssuer
PA 16357OtherCAMEDICAL LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060721000262 CA Practitioner - Physician Assistant 7517970338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Central Coast Health CentersGroup PAC ID 9739091364, 247 clinicians

Practice addresses (Care Compare)

117 W Bunny Ave
Santa Maria, CA 93458-2805
Phone (805) 739-3890

1510 E Main St
Suite 104 C
Santa Maria, CA 93454-4825
Phone (805) 349-8514

2271 S Depot St
Santa Maria, CA 93455-1216
Phone (805) 922-0561

877 Oak Park Blvd
Pismo Beach, CA 93449-3292
Phone (805) 474-8450

Hospital & facility affiliations

  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 16357CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers CurrentSince Jan 31, 2018 Accepting new patients
Pacific Central Coast Health Centers CurrentSince Jan 31, 2018 Accepting new patients
Med-Stops Medical Clinic, Inc. CurrentSince Jan 1, 2004 Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients

Locations

5920 West Mall
Atascadero, CA 93422
Phone (805) 466-0676

217 W Central Ave
Ste G
Lompoc, CA 93436
Phone (805) 735-4292

877 Oak Park Blvd
Pismo Beach, CA 93449
Phone (805) 473-2200

1400 E Church St
Santa Maria, CA 93454
Phone (805) 739-3000

1400 E Church St
Ofc
Santa Maria, CA 93454
Phone (805) 739-3112

1510 E Main St
Ste 104C
Santa Maria, CA 93454
Phone (805) 349-8514

117 W Bunny Ave
Santa Maria, CA 93458
Phone (805) 739-3474

2271 S Depot St
Santa Maria, CA 93455
Phone (805) 922-0561

1102 E Clark Ave
Ste 120A
Santa Maria, CA 93455
Phone (805) 332-8185

283 Madonna Rd
Ste B
Sn Luis Obisp, CA 93405
Phone (805) 549-8880

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1255360772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 S DEPOT ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934551216",
            "telephone_number": "805-922-0561",
            "fax_number": "805-922-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2271 S. DEPOT STREET",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93455",
            "telephone_number": "805-922-0561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 W Central Ave Ste G",
            "address_purpose": "LOCATION",
            "city": "Lompoc",
            "state": "CA",
            "postal_code": "934362830",
            "country_code": "US",
            "telephone_number": "805-735-4292",
            "fax_number": "805-735-4293",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "877 Oak Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Pismo Beach",
            "state": "CA",
            "postal_code": "934493292",
            "country_code": "US",
            "telephone_number": "805-474-8450",
            "fax_number": "805-474-8454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5920 West Mall",
            "address_purpose": "LOCATION",
            "city": "Atascadero",
            "state": "CA",
            "postal_code": "934224232",
            "country_code": "US",
            "telephone_number": "805-466-0676",
            "fax_number": "805-466-4862",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1102 E Clark Ave Ste 120A",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934555175",
            "country_code": "US",
            "telephone_number": "805-332-8185",
            "fax_number": "805-332-8186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAHEEN",
        "first_name": "DANA",
        "middle_name": "J.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 16357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE #",
            "identifier": "PA 16357",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.